What claim change is needed?
To add the PCS code to the UB-04 form. PCS codes are the procedural classification codes, different from the ICD-10 codes, used in inpatient and hospital settings.
- Navigate to Management Center > Claim Rules
- Click "Create Claim Form Rule".
- Select the Practice.
- Name the claim rule.
- Set Claim Type to Institutional depending upon service.
- Set conditions for the claim rule to be met.
- Select the Available Behavior: PCD Codes.
- Then click Add.
- Input the PCS code(s) related to the scenario in question.
- At the bottom of the window, click the Create button.
To read more about how to set claim rule conditions and order, see the Claim Rule: Setting Claim Rule Conditions article.
To read more about how to set up a claim rule to be effective as of a certain date, see the Scheduled Change Sets article.